微创食管癌切除术应注意的问题

Points for attention in minimally invasive esophagectomy

  • 摘要: 食管癌居全球常见恶性肿瘤发病率的第8位,是一种严重威胁人类健康的消化系统肿瘤。开放食管切除和区域淋巴结清扫是治疗局限性食管癌的标准手术方式,但手术并发症发生率和病死率较高。与传统开放手术比较,微创食管癌切除术(MIE)具有出血量少,并发症发生率低,住院时间短等优势,而肿瘤切除、淋巴结清扫及术后病死率与开放手术相当。结合第三军医大学大坪医院野战外科研究所全军胸外科研究所的临床经验,展开讨论对MIE手术指征和禁忌证的把握,手术方式和径路的选择,手术体位的选择,术后并发症的预防,以及MIE的学习和掌握,以期有助于MIE的推广和普及。

     

    Abstract: Esophageal cancer is ranked the eighth most common cancer worldwide, which severely threatens the health of human beings. Radical esophagectomy and regional lymphadenectomy through open approach offer the standard management for patients with locoregional disease, but it is associated with significant postoperative morbidity and mortality. It has been reported that minimally invasive esophagectomy (MIE) is associated with a substantial decrease in blood loss, complication rate and duration of hospital stay, and the resection rate, lymph node dissection and postoperative mortality were comparable to those of traditional open surgery. In this article, current views related to indications and contraindications, surgical options, operative positions, prevention of postoperative complications, as well as learning curve of MIE were discussed so as to promote the popularization of MIE.

     

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